The use of Amplatzer devices to occlude vascular fistulae

The Amplatzer occluders are Nitinol-based devices that are preshaped for specific indications, primarily to close atrial septal defects, patent foramen ovale/fenestrations, or to occlude patent arterial ducts or one designed specifically for closure of ventricular septal defects. The flexible quality of the Nitinol together with the different designs of Amplatzer occluders make it possible for these plug devices to be used for conditions other than what they are designed for. This is particularly the case for fistulae where no specific devices are available and hence improvisation may be required. The established use of the Amplatzer occluder devices primarily for atrial septal defects and for patent arterial ducts provide the confidence to use them for alternative conditions where few or no alternatives are available or if surgery is the only option. This article describes the use of Amplatzer occluder devices for two unusual conditions, namely to occlude a pulmonary arteriovenous malformation and to close an aorto-left ventricular tunnel.